1265530851 NPI number — ASSOCIATED NEUROLOGISTS OF N.J., PA

Table of content: (NPI 1265530851)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265530851 NPI number — ASSOCIATED NEUROLOGISTS OF N.J., PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ASSOCIATED NEUROLOGISTS OF N.J., PA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1265530851
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1245 WHITEHORSE MERCERVILLE RD
Provider Second Line Business Mailing Address:
SUITE 415
Provider Business Mailing Address City Name:
HAMILTON
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08619-3831
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
609-581-2300
Provider Business Mailing Address Fax Number:
609-581-7901

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1245 WHITEHORSE MERCERVILLE RD
Provider Second Line Business Practice Location Address:
SUITE 415
Provider Business Practice Location Address City Name:
HAMILTON
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08619-3831
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
609-581-2300
Provider Business Practice Location Address Fax Number:
609-581-7901
Provider Enumeration Date:
09/20/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
CAMISO
Authorized Official First Name:
TRACI
Authorized Official Middle Name:
LYN
Authorized Official Title or Position:
OPERATIONS MANAGER
Authorized Official Telephone Number:
609-581-2708

Provider Taxonomy Codes

  • Taxonomy code: 2084N0400X , with the licence number:  25MA04107600 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 2084N0400X , with the licence number: 25MA05766300 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 2084N0400X , with the licence number: 25MA07228400 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 2084N0400X , with the licence number: 25MA07884700 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 2084N0402X , with the licence number: 25MA04107600 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 2084N0600X , with the licence number: 25MA04107600 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 2084N0600X , with the licence number: 25MA05766300 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 2084N0600X , with the licence number: 25MA07228400 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 2084N0600X , with the licence number: 25MA07884700 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 3426807 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".